Let Marsh Find You the Right Long-Term Care Insurance You create a brighter future. We work to protect it. Let us help find the right Long-Term Care insurance plan for you, so you can spend time on things that matter the most. People are living longer these days, but as life expectancies increase, so does the risk of serious health problems that could require long-term care. In fact, at retirement age, 70% of Americans will need long-term care and 40% will enter a nursing home.1 And with the average cost for nursing home care in a semiprivate room equating to ... August 9, 2013 General Long-Term Care Insurance, Marsh 0 0 Comment Read More »
Physicians urged to call Gov. Brown and ask him to sign the Maddy EMS Fund bill The California Medical Association (CMA) and the American College of Emergency Physicians (ACEP) are cosponsoring a bill that will extend funding for the Maddy Emergency Medical Services (EMS) Fund. Without this bill (SB 191/Padilla), providers of emergency medical care throughout the state will lose $50 million per year that is currently used to offset the costs incurred for care provided to uninsured patients in hospital emergency rooms (ER). Without this bill, the law that authorizes the Maddy Fund is set to expire on January 1, 2014. Although the bill is ... August 8, 2013 General EMS/MADDY Funds, Access to Care, Advocacy, Emergency Rooms 0 0 Comment Read More »
Public trust in physicians an asset in the coming MICRA fight By now, you’ve likely heard that Consumer Watchdog, a political astroturf group backed heavily by California’s trial attorneys, has thrown its weight behind a ballot initiative that seeks undo major provisions of California’s Medical Injury Compensation Reform Act (MICRA). Should MICRA be touched, it would severely limit access to care of millions of patients across the state. Rest assured, this initiative is misguided and fueled by the trial attorneys' desire to inflate jury awards as a way to increase the legal fees they can collect from their clients. The California Medical Association ... August 8, 2013 General Access to Care, Medical Malpractice, MICRA, Professional Liability 0 0 Comment Read More »
Learn about Noridian's Provider Portal, Endeavor One of the frequently asked questions on the Medicare transition is whether or not Noridian has a product similar to Palmetto’s Online Provider Services (OPS) portal. Noridian does have a similar provider portal called Endeavor. Noridian is conducting web-based workshops on Endeavor. This Medicare Part A and B workshop will be conducted through a web-based training tool that requires an Internet connection. The training will last approximately one hour, including time for questions. Physicians interested in Endeavor are encouraged to attend one of the following workshops: Aug. ... August 7, 2013 Medicare Medicare Transition, Noridian, Webinars, Medicare 0 0 Comment Read More »
Anthem Blue Cross announces changes to reimbursement policies and claims software In late July, Anthem Blue Cross sent physicians a notice advising of upcoming changes to the insurer’s reimbursement policies and claims editing software called ClaimsXten. The changes will go into effect on November 1, 2013. Because of these changes, physicians may notice a difference in how certain codes and code pairs are adjudicated. Along with the notice, Anthem provided a comprehensive grid outlining all new, revised and existing reimbursement policies and claims editing rules as well as copies of Anthem’s reimbursement policies. Changes include: denial of 3D rendering CPT codes 76376 ... August 7, 2013 Managed Care Insurance/Reimbursement, Managed Care, Anthem Blue Cross 0 0 Comment Read More »
Nurse practitioner scope-of-practice bill fails in committee A bill that would give California's nurse practitioners more autonomy failed on a vote of 6-3 Tuesday in an Assembly Business, Professions and Consumer Protection Committee. The bill (SB 491) would allow nurse practitioners to open practices without any oversight from a trained medical doctor and prescribe dangerous, addictive drugs without supervision. Although the bill failed to pass committee today, it was granted reconsideration and will be voted on again next week. While an important part of the health care delivery system, nurse practitioners simply do not have adequate training ... August 7, 2013 General Advocacy, Nurse Practitioners, Scope of Practice 0 0 Comment Read More »
Resources to assist physicians with the Medicare contractor transition Goal: Provide members with information and resources to prepare their practices for the transition of Medicare contractors from Palmetto to Noridian on September 16 (Part B). Current CMA Resources 1. CMA’s Medicare Transition webpage – CMA has created a dedicated Medicare transition webpage, www.cmanet.org/medicare-transition, offering practices the ability to access updates and important information regarding the transition in one easy-to-access to location. All resources related to the Medicare transition will be accessible through this site. 2. CMA’s Medicare Transition Guide: What physicians need to know – This guide, which members can download free ... August 1, 2013 Medicare Medicare Contractors, Noridian, Palmetto, Medicare 0 0 Comment Read More »
Medicare locality reform ("The California GPCI Fix") clears House Congressional Committee as part of the Medicare SGR overhaul legislation On July 31, the House Energy and Commerce Committee voted unanimously to approve a BIPARTISAN Medicare Sustainable Growth Rate (SGR) overhaul legislation, H.R. 2810. Included in the bill is the CMA-sponsored California Medicare locality reform known as the “California GPCI Fix.” The California locality provision is a compromise between Committee Chairman Fred Upton (R-MI) and Ranking Democrat Henry Waxman (D-CA) who insisted the California update be part of the committee bill. It is based on legislation by Congressman Sam Farr (D-Santa Cruz/Monterey) and Darrell Issa (R-San Diego) who are ... July 31, 2013 Medicare California GPCI Fix, SGR, Sustainable Growth Rate, Medicare 0 0 Comment Read More »
CMA urges CMS to postpone changes to QIO program The Centers for Medicare and Medicaid Services (CMS) recently called for public comments on how it can best organize the national cadre of Medicare Quality Improvement Organization (QIO) contractors. The mission of the QIO program is to improve the effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. Currently, CMS contracts with one organization in each state to serve as that state's QIO contractor. QIOs are private, mostly not-for-profit organizations, staffed by physicians and other health care professionals who are trained to review medical care, help beneficiaries with ... July 25, 2013 Medicare Centers for Medicare and Medicaid Services, Insurance/Reimbursement, Quality of Care, Medicare 0 0 Comment Read More »
CMA files amicus brief in physician whistle-blower case Last week, the California Medical Association (CMA) and the American Medical Association (AMA) filed an amicus curiae brief in the California Supreme Court to urge for broad protection of physician whistleblowers in hospitals. The brief focuses on a medical staff physician’s rights as a whistleblower under Health & Safety Code section 1278.5. In the case, Fahlen v. Sutter Central Valley Hospitals et al., the plaintiff physician alleged that his staff privileges were terminated in retaliation for reporting nursing errors and insubordination to the hospital. He sued the hospital under section ... July 25, 2013 General Hospitals and Health Facilities, Peer Review, Legal Advocacy 0 0 Comment Read More »
